The arrival of COVID-19 in Brazil and the impact on coronary artery bypass surgery

Author(s):Show less -

Mejia, Omar A. V. ; Borgomoni, Gabrielle B. ; Silveira, Lucas M. V. ; Guerreiro, Gustavo P. ; Falcao Filho, Alexandre. T. G. ; Goncharov, Maxim ; Dallan, Luis R. P. ; Oliveira, Marco A. P. ; de Sousa, Alexandre G. ; Nakazone, Marcelo A. ; Tiveron, Marcos G. ; Campagnucci, Valquiria P. ; Silva, Pedro G. M. ; Dallan, Luis A. O. ; Lisboa, Luiz A. F. ; Jatene, Fabio B. ; REPLICCAR Study Grp

• Document type: Journal article
• Source: JOURNAL OF CARDIAC SURGERY; v. 36, n. 9, p. 8-pg., 2021-06-06.

Abstract

Background and Aim of the Study This study analyzed the arrival of coronavirus disease 2019 (COVID-19) in Brazil and its impact on coronary artery bypass grafting (CABG) surgery. Methods Patients undergoing isolated CABG in six hospitals in Brazil were divided into two periods: pre-COVID-19 (March-May 2019, N = 468) and COVID-19 era (March-May 2020, N = 182). Perioperative data were included on a dedicated REDCap platform. Patients with clinical and tomographic criteria and/or PCR (+) for severe acute respiratory syndrome coronavirus 2 infection were considered COVID-19 (+). Logistic regression analysis was performed to create a multiple predictive model for mortality after CABG in COVID-19 era. Results Compared to 2019, in 2020, CABG surgeries had a 2.8-fold increased mortality risk (95% confidence interval [CI]: 1-7.6, p = .041), patients who evolved with COVID-19 had a 11-fold increased mortality risk (95% CI: 2.2-54.9, p < .003), rates of morbidities and readmission to the intensive care unit. The surgical volume was decreased by 60%. The model to predict mortality after CABG in the COVID-19 era was validated with good calibration (Hosmer-Lemeshow = 1.43) and discrimination (receiver operating characteristic = 0.78). Conclusion The COVID-19 pandemic had an adverse impact on mortality, morbidity and volume of patients undergoing CABG. (AU)

• FAPESP's process: 16/15163-0 - Expansion and enhancement of 'paulista cardiovascular surgery registry' through partnership with the Massachusetts State Registry/Harvard University for quality improvement programs in cardiac surgery at the São Paulo State Public Healthcare System
• Grantee: Omar Asdrúbal Vilca Mejía
• Support Opportunities: Research Grants - Research in Public Policies for the National Health Care System (PP-SUS)